I spent last weekend in Illinois to perform at a comedy club in my hometown. I also visited my dad, so of course I’ve once again got Alzheimer’s on my mind (no pun intended).

The good news is that Dad was having one of his better days when Mom and I took him out to lunch. He called me by name twice and was able to participate in the conversation a bit. He spoke briefly with a friend who happened to at a nearby table and seemed to recognize him.

Amazingly, he still shows flashes of humor. A couple of times, he got that old twinkle in his eye and said something funny — on purpose. A few weeks ago, when a lifelong friend of his was visiting and complained that a hair stylist had “gone a bit short” with her haircut, Dad turned to her very bald husband and said, “Looks like that stylist went a bit short on you too, huh, Bob?” I don’t know how a mind that can’t grasp the concept of putting on shoes can still generate humor. Maybe it’s in his DNA. I told my mom I think every Irishman’s secret wish is to die five seconds after saying the funniest line of his life.

The bad news is that his better days still aren’t good. While trying to help him put his coat on after lunch, I couldn’t get him to understand that he needed to move his arm backwards, not forwards. As my mom took him back inside the nursing home, he said, “I’m tired. I probably won’t go into the office tomorrow.” I guess those walkers will have to go unsold for a day or so.

My older brother was in the audience for the Friday-night standup show, and we talked about Dad’s condition afterwards. After I recounted the lunch with Dad, my brother said, “Well, we’re screwed.” (He was slightly more colorful, but you get the idea.) I asked why he thought so.

He replied, “Grandpa Markwell [our great-grandfather] didn’t start getting senile until he was 98. For Grandma Naughton, it was in her 80s, and for Dad, it was around 70. We’re screwed.”

I don’t think so, at least not in my case. When it comes to disease, genetics may load the gun, but we can avoid pulling the trigger. I know better than to shoot myself. Dad made two big mistakes I won’t repeat: he became a bit of sugar freak after he quit smoking (and almost certainly became progressively more insulin resistant, judging by his girth), and he took Lipitor for more than twenty years. I’ve mentioned both before, but let’s take a more detailed look.

First, statins: If you want to delve into the chemistry of how statins affect brain function, you can read this article. In the meantime, here are a few highlights:

There is a clear reason why statins would promote Alzheimer’s. They cripple the liver’s ability to synthesize cholesterol, and as a consequence the level of LDL in the blood plummets. Cholesterol plays a crucial role in the brain, both in terms of enabling signal transport across the synapse and in terms of encouraging the growth of neurons through healthy development of the myelin sheath. Nonetheless, the statin industry proudly boasts that statins are effective at interfering with cholesterol production in the brain as well as in the liver.

Researchers are only recently discovering that both fat and cholesterol are severely deficient in the Alzheimer’s brain. It turns out that fat and cholesterol are both vital nutrients in the brain. The brain contains only 2% of the body’s mass, but 25% of the total cholesterol. Cholesterol is essential both in transmitting nerve signals and in fighting off infections.

High cholesterol is positively correlated with longevity in people over 85 years old, and has been shown to be associated with better memory function and reduced dementia. The converse is also true: a correlation between falling cholesterol levels and Alzheimer’s.

Put yourself on Lipitor, and we can pretty much guarantee that your cholesterol will fall. That’s the supposed benefit. But …

Yeon-Kyun Shin is an expert on the physical mechanism of cholesterol in the synapse to promote transmission of neural messages. In an interview by a Science Daily reporter, Shin said: “If you deprive cholesterol from the brain, then you directly affect the machinery that triggers the release of neurotransmitters. Neurotransmitters affect the data-processing and memory functions. In other words — how smart you are and how well you remember things.”

A second way (besides their direct impact on cholesterol) in which statins likely impact Alzheimer’s is in their indirect negative effect on the supply of fatty acids and antioxidants to the brain. It is a given that statins drastically reduce the level of LDL in the blood serum. This is their claim to fame. It is interesting, however, that they succeed in reducing not just the amount of cholesterol contained in the LDL particles, but rather the actual number of LDL particles altogether. This means that, in addition to depleting cholesterol, they reduce the available supply to the brain of both fatty acids and antixodiants, which are also carried in the LDL particles. As we’ve seen, all three of these substances are essential to proper brain functioning.

The bottom line: your body makes cholesterol for a reason. Beat down your cholesterol with a drug, and you’re messing with your biochemistry at the cellular level. Not a good idea.

Of course, plenty of people who don’t take statins develop Alzheimer’s as well. I doubt statins are a major cause of the disease. But insulin resistance could be.

As Gary Taubes explains in Good Calories, Bad Calories, since neurons in the brain ideally last for a lifetime, they may be prime candidates for the accumulation of advanced glycation end-products, or AGEs — proteins linked haphazardly with sugars. (The acronym is convenient if not intentional; AGEs literally age your tissues.) AGEs appear to be involved in the early stages of the amyloid plaques that form in the brain. That means the foods that spike your blood sugar are already causing trouble. As an article on AGEs and diabetes explains:

A lowered glucose concentration will unhook the sugars from the amino groups to which they are attached; conversely, high glucose concentrations will have the opposite effect, if persistent.

And of course, when you spike your blood sugar, your body spikes its insulin output in response. If you become insulin resistant, your insulin will be high all the time — which in turn inhibits your brain’s ability to clear away plaques. As Gary Taubes wrote:

Insulin (in a test tube) will monopolize the attention of insulin-degrading enzyme (IDE), which normally degrades and clears both amyloid proteins and insulin from around the neurons. The more insulin available in the brain, by this scenario, the less IDE is available to clean up the amyloid, which then accumulates excessively and clumps into plaques … Mice that lack the gene to produce IDE develop version of both Alzheimer’s disease and Type 2 diabetes.

Other research has shown that insulin receptors in the brain can become resistant and waste away, just as they can in the muscles and other organs. No wonder some researchers are beginning to refer to Alzheimer’s as Type 3 diabetes.

Some months ago, I mentioned the HBO series The Alzheimer’s Project. I’ve included a 21-minute clip that addresses insulin resistance below.

I found this section of the series interesting but also somewhat annoying. Dr. Craft, the expert interviewed here, makes a good case for insulin resistance causing Alzheimer’s. But of course, she’s convinced complex carbs are good and saturated fat is bad. For the gazillionth time, complex carbs are only good compared to refined carbs. They are not good in and of themselves. Eat enough of them, and you’ll still spike your blood sugar.

She also mentioned only two diets being tested for their effects on insulin: a high-sugar/high-fat diet and a low-sugar/low-fat diet. Now, the sad truth is, when you eat refined carbohydrates and fat together, it’s the worst combination of all, for all kinds of reasons. But take away the carbohydrates, and the fat isn’t a problem. As the first article I linked points out, fats are crucial for brain function. So why aren’t the researchers including a high-fat/low-sugar diet in this study? After all, ketogenic diets have been shown to prevent plaques, at least in mice. Ketones have also been shown to improve memory in humans with Alzheimer’s.

As I mentioned before, my mom is an optimistic person and she’s handling Dad’s situation well. My wife is also an optimistic person, but I don’t want her to handle a similar situation – ever. When I’m 70, she’ll only be 56. My daughter Sara will only be 25. Alana will be 23. I’m pretty sure none of them will be ready yet to deal with seeing me fade away, as we’ve seen my dad fade away.

Great-Grandpa Markwell was sharp until he was 98 and, by the way, lived to see his 101st birthday. I still remember taking a walk with him when I was an adolescent — he was in his late 80s — and struggling to keep up. I plan to follow in those footsteps, not my dad’s. That’s one of the many reasons I eat the way I do.

Hi Tom, From everything I’ve read and learned over the last few years, I’m convinced you are eating the best way possible to avoid health problems like this. Since my husband was told he has epilepsy due to a brain tumour, that’s the way we eat too.. it’s hard what with all the sugar-free ice cream, steaks in cream sauce and creamy gateaux we have to eat.. but we stick with it!!
I am now trying to convert my father-in-law who has just been told he has cancer of the esophagus to swap from high-fibre cereals and low-fat spreads to cream, butter and fatty meats. The trouble is my sister-in-law is a health advisor and will probably fight us. Experts, eh?

I’m afraid the experts have caused more damage than they could ever know.

When I came out of the hospital in March (& April & May) of 2008, I was on a statin to control my very good cholesterol levels. Why? It’s standard procedure for those with high blood pressure. I couldn’t read or write for awhile. Something happened. My memory was crappy to say the least. It took months for me to be able to read again. My memory was still crappy–I had a hard time remembering important things. The worse part of it was I was gaining weight no matter how little I ate. I ballooned up to a size 24.

This year, I had been reading some horrific things about other statin drugs and came to the conclusion that my cholesterol levels were still good. So why was I taking this medication? I weaned myself off–you cannot quit these drugs. My GP had a hissy, my cardiologist had a hissy. I take niacin supplements to “help control my cholesterol.” When I remember. *grins* My diet means staying off all processed and refined anything foods, avoiding corn and soy, and doing the low-carb thing. I eat a lot of fresh fruits and veggies as well. I work to avoid carbs for the most part.

My memory started improving after I got off the cholesterol lowering drugs. I’m losing weight still–which is good. But my doctors are waiting to say, “I told you so” and put me back on the drug. And I’m telling them differently!.

My dad’s cardiologist had a hissy when he quit the Lipitor. You’d think people who refuse statins are threatening to go out and swallow some hemlock.

Aaarrrggghhh! Who is paying for Dr. Craft’s research? How did she decide saturated fat (represented as sticks of butter!) is the problem rather than the two enormous bagels AND an big sandwich roll AND two dinner rolls plus mashed potatoes (and no non-starchy vegetables I could see) she’s feeding people in a day? What happened to the sugar and starch? Where do they fit in? The “high-sugar” part of the equation seems to mysteriously disappear.

She also seems to imply obesity causes insulin resistance–isn’t that backward?

I think insulin resistance in the population is more like 75 to 80%, not 30%. I notice that in any group of 10 people, there are two or three at most who don’t exhibit outward signs of insulin resistance (and of course some people don’t show it with weight gain, puffiness, etc.), not seven. (And I can’t help but notice Dr. Craft looks pretty puffy herself.)

Thanks, Tom, for an interesting post.

I’m afraid she’s been brainwashed when it comes to diets. Low-sugar/low-fat is the only healthy option she can think of. She’d probably dismiss high-fat/low-sugar as a ridiculous idea.

Wow, great post!!!! I often wonder why the concept of a High Carb/Low fat diet is set in stone? And since it became set in stone, we’ve had such a dramatic rise in so many autoimmune diseases and things like ADHD and depression. I’m beginning to think the modern diet has ruined the reasoning ability of our scientists and doctors, and alas we can expect no better! I also think their brains have become too yeasted out as well. How else to explain it, otherwise more of them would do thier homework. My other theory is that illiteracy is more common than we’d like to think, affecting much of our medical community. After all, it’s easy to dig in medical journals and read about this.

The rate of Alzheimer’s is up too; no surprise with the rise in diabetes. With teens becoming insulin-resistant and diabetic now, I can’t imagine what the disease rates will be 40 years from now. Let’s hope medical knowledge about diet makes a huge leap forward before then.

Thanks for such a lucid description of how it all works.
Cholesterol is amazing stuff.
Blaming cholesterol for illness is like blaming bandages for causing wounds.
re Snowdog – You don’t need to be in ketosis to benefit from a better FAT/carb balance.

Good analogy, and I think statins strip away the bandages we need when we need them.

Great article. My 91 year old Dad has vascular dementia, good and bad days, but it is obviously progressing. He is also on Lipitor, something I have protested vehemently. (First heard of negative reports on Lipitor from spacedoc.com. )

Question: any research you’ve found connecting AGE’s to glaucoma? I have pigmentary glaucoma, thought I once read of some connection but cannot find anything….? Thank you.

I believe Nora Gedgaudas may have mentioned that in Primal Body, Primal Mind, but I lent out my copy and can’t look it up right now. It certainly makes sense.

Strictly anecdotal, but an elderly friend of mine has been giving her husband (with Alzheimers) niacinamide with some success. He had been on Aricept with no results. She said she’s read that she should give it at least 3-4 months to see significant improvement (he’s been taking it for 2), but he’s started to interact more (and has stopped trying to clear out the house; he threw all of her shoes away!). His doctor has noticed the improvement at his last exam and is intrigued.

I’ll definitely pass that on to Mom. Dad’s had some shoes disappear in the nursing home, but also ended up with some women’s clothes in his closet. Families have to stitch name tags into clothes like you would with kids.

Part of what you wrote here is one of the reasons I went paleo with my eating. Not only do I not want anyone taking care of me prematurely, I turn 50 in April, and decided that if you gotta hit 50 and beyond, I’m NOT going to look like all my friends, which is mostly fat around the middle and out of shape, and either diabetic, statinated or both. I am, and plan to be, in the best shape of my life.
I also see a lot in the medial end of things (I work for a cardiac-oriented home health agency). Most of what’s going on here could have been prevented just by eating right. It seems like so many people 60 and older are professional patients. Their entire life is their sickness. It is there identity. Their life, such as it is, revolves around their sickness and infirmity. It’s not uncommon for these people to be on 25-30 medications. Most are on statins, some are on two. It’s so incredibly sad. And I blame conventional medical wisdom for half of it, because being on that end, we are at fault for spewing the diet related garbage that’s been produced that past 50-60 years.
And yet… when people tell me I look great, and I tell them how I did it, mostly what I get is “oh, I couldn’t do that. No grains? That can’t be good”.
NOT ME. I refuse to be one of them. Congratulations to you, and the others here that have figured out that conventional wisdom is wrong.
But I ramble. Thanks for your work and research!

I’m afraid I see much of the same. Look around at my contemporaries, and pretty much everyone is overweight, tired-looking, or on some kind of prescription — although I’m proud to say I blitzed a longtime friend with information about statins and he quit taking Lipitor. Meanwhile, I feel pretty good. I was recently at a business meeting, talking with two other people who just turned 50, and I suggested we should start an unofficial over-50 club … at which point one of them refused to believe I’m 51 until I pulled out my drivers license. She thought I was “maybe 40, tops.”

On dementia, Stephan Guyenet states on his blog, Whole Health Source, ..”the chain of causality seems to pass through visceral fat and insulin signaling…” Dr Craft explains the role of insulin very well and then completely goes off track when she blames saturated fat! Fats, even the truly nasty ones like PUFAs and trans fats, do not raise insulin or cause insulin resistance. It is truly criminal that families desperate to find an answer to their loved ones’ dementia would take this as yet more reason to abandon a nutrient that may actually help. Natural saturated fats, especially in the form of medium-chain triglycerides, are necessary for healthy brain (and body) function. And how to we lose that visceral fat most effectively? Through a low-carb, “bad” saturated fat diet.
We are eight years eating this way, also determined to not to be “one of them”. It is a constant battle to fight the disease-producing “healthy eating” garbage, as Barry Groves calls it. Thanks for being a soldier out there on the front lines, Tom.

My reaction exactly. The HBO series was probably seen by millions. If some of them are inspired to give up sugar, great. But giving up natural fats is counter-productive.

So, do you have any idea what kind of diet your Great-Grandpa Markwell ate?

Thanks

He was a farmer born in the 1880s. We know he didn’t eat frankenfoods for much of his life because they weren’t around. I know he liked his bacon and eggs, and my grandma cooked with lard, so I’m guessing he did too. What I remember most about him (besides his quick pace when walking, which he did nearly all the time, no matter the weather) was that he always seemed to be smiling or laughing.

I also remember my dad giving him a bottle of his favorite “sippin’ whiskey” during one visit. Great-Grandpa, who was 95 at the time, thanked him for it and said it would last a long time because he only sipped a bit each night. Dad said, “That’s good, Granpda. You keep that up, you might live to be an old man.” Great-Grandpa turned to me and said, “He’s kiddin’ me, you know.”

Yeah, you don’t look 50-ish. Surely your youthful appearance can’t be due to that high fat diet you follow, though … I thought maybe it was the Grecian Formula. 🙂 (I wonder if they use real Greeks to make it.)

Hey, just saw this bit about a UK dietitian making lots of healthy recommendations and getting in trouble for it (although the technical accusation was poor record keeping and not providing clinical reasons for her recommendations).

Are you able to provide recommendations/websites on how to safely wean a person off statins? I am convinced my 88 year old grandfather’s muscle weakness is due to statins. Thank you so much for continuing to post about these issues.

I’m not aware of a single best way to come off of them. Some people quit cold turkey, some reduce the dose by 1/3 per month until they hit zero.

Tom, thanks for posting this, more people need to hear it. I point people to my website pages on statins and cholesterol all the time, but most give the standard “but my doctor says” response.

There’s a man at my workplace who is on Lipitor and is slowly losing his mind (he couldn’t remember my name, or how to do the most basic computer tasks today) and when I tried to tell him about the side effects of Lipitor, he said “my doctors have tested for that possibility and they say statins don’t do that”. So I stopped trying to tell him. It is saddening to see his decline, knowing what I know, and heartbreaking to see his frustration at not being able to remember the most basic information. He is a nice man and doesn’t deserve to go through what he is experiencing.

I think every CEO and board member of every statin pushing drug company should be prosecuted for attempted homicide. And, they should have to take statins in large doses.

Maybe they do take them so they can forget the damage they’re causing.

Being Irish myself, I agree that humour is more important than sex. I do have one question – how does an Irishman know when he has been his funniest, were he to rely on his best friend he might die prematurely!

Good question. When I’m, say, 95 I’ll start trying out my best lines and see what happens.

Leptin is involved in hunger signals. Low leptin, you feel hungry. Higher leptin, you feel satisfied — if your system is working correctly. Unfortunately, people can become leptin-resistant, just as they can become insulin-resistant. When that happens, even high levels of leptin don’t put the brakes on your appetite.

Now, is it leptin per se that protects against Alzheimer’s? Maybe. Or it could be an association; people with naturally high leptin may feel satisfied on less food and naturally tend to eat less, which would help keep blood sugar in check.

Makes me happier than ever that I realized in only 3 months of taking Lipitor what it was doing to me, and steadfastly refused to have anything to do with any kind of Statin drug from that point forward. My concentration was shot. I couldn’t remember how to write code clearly. Couldn’t finish a project, and was in danger of losing my job. In only 3 months of taking it. Sadly, I’ve been unable to make any progress in convincing my best friend, whose type 2 diabetes has progressed to the point that he’s having to inject insulin daily, to even consider changing his diet. I blame the 3 or 4 statins he’s on for making it so he can’t think straight, despite all the clear evidence that it’s his diet that’s killing him.

If this keeps up, we’ll turn into a nation of people who can’t remember anything. I guess the good news for me is that I’ll be able to do the same standup material for the same audiences over and over.

“If the FDA accepts this recommendation, it will expand the number of Americans eligible for statin therapy by millions,” said Dr. Steven Nissen, chair of cardiovascular medicine at the Cleveland Clinic.

And there we have it. It will also “expand by millions the number of dollars raked in by AstraZeneca”.

Of course insurance will pay, then rates go up to pay for it. Then rates go up to treat all of the side effects.

It sometimes saddens me to be associated with the medical industry. It’s like they told me in nursing school “healthcare is all about who lives, who dies, and who pays”.

Statins may even go over-the-counter at some point. Imagine millions of brainswashed people beating their cholesterol down because they’ve been told they should.

I don’t think it’s a coincidence that ketogenic diets have been used to treat a number of neurological diseases – from Alzheimer’s to Parkinsons to, classically, intractable epilepsy.

There’s even evidence – in rats – that a ketogenic diet, combined with calorie restriction, can reduce and even reverse the progression of brain tumors. The diet in question was noted as a soybean oil-based commercial diet typically prescribed to epileptic children. Which, naturally, makes me wonder if it might be possible to get even better results if highly saturated (gasp!) fat, such as butter or coconut oil, were used as the basis of the diet instead, as PUFAs in veggie oils can aggravate cancers. Maybe they could even skip the calorie restriction part. But, sigh, we may never know because of the stupid bias nearly everyone in nutrition research has against saturated fats.

I have had epilepsy since the age of 15 (I’m now 49). Since I eat a pretty high fat diet now, I’m considering getting off the Depakote that I’ve been taking for the last 30 years. What’s amazing is my neurologist agrees that I can give it a try, since I’ve been seizure free since the age of 27. It’s a big step though. I’ve been able to take the depakote with basically no side effects for all this time…

The Alzhiemer’s Project has some excellent videos that I hope everyone will watch
However, I think it is sad they felt it necessary to remove the comments from their science section.
There are aspects of the care of the elderly and those with dementia that can be improved.
I don’t think Vitamin D status is mentioned in any of their videos yet vitamin D3 deficiency in the elderly is the rule. It is a matter that can be sorted cheaply and quickly.

UVA processes any vitamin D near the surface of the skin into suprasterols the body doesn’t use so the favorite occupation of many elderly people, sitting by a sunny window or in a sunny conservatory will be further depleting their already low D3 status.
Low vitamin D means low calcium absorption.
The most numerous cells in our brains, astrocytes, communicate via calcium exchange.It isn’t surprising that low vitamin D status is associated with poorer cognitive performance

I can’t remember now what comment I left under the Craft video but it was polite and evidence based.

If the science they present isn’t able to stand logical scrutiny then they have to be open to other ideas. Simply ignoring or refusing to listen to other science that shows different results is not going to solve the problem.

One if the things I noticed about the personal Alzheimer’s stories illustrated at the Alzheimer’s Project is the amount of carb eating that is shown.
One might well think that Carb addiction is a feature of Alzheimer’s.

That’s what struck my wife and me as well — Alzheimer’s patients at home, eating potatoes, noodles, cookies, cakes, pies. It was like a sugar-fest on parade.

Statins also suck out what little Coq10 ones body produces with the majority of that coming from the heart. So needless to say the millions who are taking these statin drugs inevitably end up with many heart issues ahead of them including bypass. It amazes me that my grandparents never took pills. They both lived to ripe old ages. But then again they didn’t feed on McDonalds, and the like every day or every week for their nourishment. It’s a lose lose situation I think with our nation today between the availability of so much processed food at our disposal, no wonder the drug companies are the ones with the last laugh. But I will stand firm on being told I must take this pill or that pill in order to live. Sadly at the present time no one in my family has health coverage so we just live day to day. Genetics are to blame to a certain extent, but we all know with prescription drugs come the many side effects to anyone that takes them. I tend to go the herbal direction and do exercise as much as my schedule allows me. Last I recall the other Country besides the US that can legally show commercials of their prescription drugs is New Zealand. This should be a wake up call in itself.

I’ve become quite a minimalist when it comes to prescription drugs myself. If I’ve got a nasty baterial infection and it’s not going away, sure, I’ll take the antibiotic. But other than that, I pretty much avoid them.

The film follows Donal – a lean, fit, seemingly healthy 41 year old man – on a quest to hack his genes and drop dead healthy by avoiding the heart disease and diabetes that has afflicted his family.

Donal’s father Kevin, an Irish gaelic football star from the 1960s, won the first of 2 All Ireland Championships with the Down Senior Football Team in 1960 before the biggest crowd (94,000) ever seen at an Irish sporting event.

When Kevin suffered a heart attack later in life, family and friends were shocked. How does a lean, fit and seemingly healthy man – who has sailed through cardiac stress tests – suddenly fall victim to heart disease?